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When a Patient Leaves Your Practice for Good

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Dr. Daniel Hoffman's guide on what to do if your patient has to leave your practice, for one reason or another.

We all have patients who leave our practices over the years for a variety of reasons. Some will pass away, while others move from the area or insurance changes that no longer cover services at our office.

How we handle the patient changes are important. If a patient passes, the office sends the family a card with a short note about the patient. We are happy to fill out insurance or other forms that may be necessary to help the family. Patients that move, we ask them to come to the office so that they can be given a 90-day supply of medication and obtain a copy of their medical records. The medication gives them time to locate a new physician where they relocate and having the records in hand helps the new doctor treating them. Patient with insurance changes I make sure they have at least a 30-day supply of all the medications until they can see a doctor in the area who accepts their new insurance. I also tell them to stop by the office to get a copy of the records.

My state has established a medical record copy fee schedule and the patient is given this along with a bill for the records. If a patient is needy, I will exercise my right to waive the fee but all others do have to cover the records charges as it takes time for the staff to print out the records. Also, it takes a long time for patients to copy the paper records that were not scanned into the computer system.

We do the best we can to transition the patient to the new physician and explain if their insurance in the future changes, they are welcome back should they so choose. Given the fact I am the only physician in the area in primary care that takes walk-ins I advise them they need to call the new physician's office to schedule appointments. If they cannot be seen in a timely manner they need to consider going to the ER or an urgent care for treatment.

They are welcome back at the office, but they must understand that they would have to cover the visit since I am not on their insurance anymore. I have been surprised at the number of patients I see back in the office when they get sick as they have limited access to the employed physician. They often pay less here than at the urgent care or ER. Over the years, I have seen a lot of patients who moved from the area but return to visit friends or family still here and become ill. They still remember that they can walk in and see me five-and-a-half days per week.

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